Macedonian Journal of Medical Sciences
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Abstract                                                                         [Full-Text PDF] [Macedonian Abstract] [OnlineFirst Full-Text PDF]


Macedonian Journal of Medical Sciences. 2008 Sep 15; 1(1):34-40.


Clinical Science


Chronic Graft-Versus Host Disease - Single Center Experience

Zlate Stojanoski1, Aleksandra Pivkova1, Svetlana Krstevska-Balkanov1, Rubens Jovanovik2, Georgi Gocev3, Sonja Genadieva-Stavrik, Lidija Cevreska1, Borche Georgievski1

1Hematology Clinic; 2Institute for Pathology; 3Dermatology Clinic; Medical Faculty, University "Ss Kiril and Metodij", Skopje, Republic of Macedonia


Background. With the increasing number of patients surviving peritransplant complications of stem-cell transplantation (SCT), the incidence of chronic Graft Versus Host Disease (cGVHD) has increased too. cGVHD now develops in approximately 30-50% of patients undergoing SCT. Risk factors associated with the development of cGVHD are: previous acuteGVHD (aGVHD), prior cytomegalovirus infection, use of a matched unrelated donor and combination of a male recipient with a female donor. Not all patients who develop aGVHD progress to cGVHD. The latter may occur de novo.

Aim. To describe clinical and patohistological findings and influence of cGVHD on survival in allogeneic stem cell recipients.

Material and methods. During 7 years period we have treated 40 patients with allogeneic SCT from HLA identical sibling. aGVHD prophylaxis comprised Seattle protocol.

Results. 12 patients (6 males, 6 females; mean age: 34,5) developed cGVHD (7 de novo). Distribution according to diagnosis: Acute Myeloid Leukemia (n=8), Chronic Myeloid Leukemia (n=3), Primary myelofibrosis (n=1). Six of them had limited disease, and 6 had extensive. Treatment comprised: corticosteroids + CsA (6), Mophetyl mycophenolate (4), Tacrolimus (2), Photochemiotherapy (3). 10 (83%) patients are alive; 2 (17%) died.

Conclusion. Despite advances in histocompatibility matching and immunosuppressive drugs, GVHD has continued to be a common and often lethal complication of SCT.


Key words: Allogeneic stem cell transplantation; graft versus host disease.


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Institute of Immunobiology and Human GeneticsSkopje, Republic of Macedonia.
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